NR 327 EDAPT FETAL ASSESSMENT AND MONITORING 2024

EDAPT FETAL ASSESSMENT AND MONITORING The primary purpose of fetal assessment during labor is to assess the oxygenation status of the fetus. Fetal assessment during the labor process is largely the responsibility of the registered nurse, who must be competent in interpreting data, implementing corrective actions to improve fetal oxygenation, accurately communicating findings with healthcare providers, and assisting in making clinical decisions to ensure the safety and quality of care. Although both low and high technology methods of fetal monitoring are used during labor, the high technology method of electronic fetal monitoring is more commonly used in the U.S. The low technology methods of intermittent fetal heart rate auscultation with doppler or fetoscope may be used depending on the stage of labor and the risk status of the patient during labor. What is a normal range for the fetal heart rate? The normal fetal heart rate ranges from 110 to 160 bpm. What does the fetal heart rate and pattern indicate, particularly in response to uterine contractions? The fetal heart rate and pattern, particularly in response to uterine contractions, are good indicators of the fetus’s condition. Which of the following variability classifications is generally indicative of fetal well-being? Moderate variability, defined as fluctuations in fetal heart rate between 6-25 bpm from the baseline, is generally indicative of fetal well-being. Minimal or absent variability may indicate fetal distress, although it does not necessarily confirm it, as minimal variability can, for example, occur during fetal sleep. Marked variability occurs as an autonomic nervous system’s response to fetal hypoxia. LEOPOLD’S MANEUVERS Accurate fetal heart monitoring begins with the correct placement of the monitoring device. Leopold’s maneuvers are a systematic assessment using hands to palpate the gravid abdomen and suprapubic area to determine fetal presentation and position. The fetal heart tones are best heard over the upper fetal back. Placement of the ultrasound transducer over the location of the fetal back will assist in accurate fetal heart tracing. The nurse ensures that the patient’s bladder is empty and assists them to a comfortable supine position with knees slightly flexed and a pillow under one hip. This allows for ease of palpation while also preventing the weight of the uterus from compressing the vena cava, which can result in maternal hypotension. There are four maneuvers that involve using both hands in different positions to palpate the abdomen and suprapubic area for the recognizable anatomical features of the fetus.